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DOJ Enforcement Actions

					
The  is the principal federal agency authorized to enforce the laws and defend the interests of the United States. As such, it oversees the enforcement of the False Claims Act, the foundation of the American whistleblower system, as well as numerous other laws.


The agency traces its origins to the Judiciary Act of 1789 which created the Office of the Attorney General, and the 1870 Act to Establish the Department of Justice, which established the agency as “an executive department of the government of the United States” with the Attorney General as its head.


The agency is comprised of numerous divisions with the Civil Division and in some instances, the Criminal Division, overseeing investigations and prosecutions under the False Claims Act. The  of the federal district where the False Claims Act case is filed also plays a key role in False Claims Act enforcement.


Below are summaries of recent DOJ settlements or successful resolutions under the False Claims Act as well as other successful prosecutions for fraud and misconduct. If you believe you have information about fraud which could give  rise to a claim for a whistleblower reward, please contact us to speak with one of our experienced whistleblower attorneys.

				

			

			
						
					
			

	
		
		

			

				
				
April 9, 2019

				 Antonio Carlos de Godoy Buzaneli of Florida was sentenced to 20 years in prison for his role in a scheme that raised approximately $150 million from investors for his company Providence Holdings International, Inc., which Buzaneli represented would invest in the factoring of accounts receivable in Brazil. In fact, much of the investors’ funds were used to make Ponzi-style payments to other investors, and to make commission payments to Providence’s nationwide network of brokers. 				 					 

						
Tagged in:
													  Criminal Proceedings, 
													  Financial and Investment Fraud, 
													  Ponzi Schemes, 
													  Securities Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
April 5, 2019

				 Philip Esformes of Miami Beach, Florida, was found guilty of crimes arising from his role in the submission of over $1.3 billion in fraudulent claims to Medicare and Medicaid.  According to evidence introduced at trial, between 1998 and 2016, Esformes, who owned a network of assisted living and skilled nursing facilities, bribed physicians to admit patients into his facilities, which were in poor condition and unable to provide adequate treatment. Patients often failed to receive appropriate medical services, or received medically unnecessary services.  Esformes was later sentenced to 20 years in prison. 				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  Criminal Proceedings, 
													  Lack of Medical Necessity, 
													  SNF, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
April 4, 2019

				 Kenneth C. Coleman of Houston, Texas, who owned Acacia Pharma Distributors, Inc. and Four Corners Suppliers, Inc., has been sentenced to 30 years in prison following his conviction at trial for money laundering, tax evasion, and related charges.  Coleman and his companies purchased second-hand prescription medications from various illegitimate sources and sold them to a third party, Green Valley Medical Distributors, LLC, which then sold the medications to pharmacies as if they were brand new.  In arranging the sales, Coleman created fraudulent documents that misrepresented the sources of the medications and their prior sales.  After being paid by Green Valley, Coleman and others would pay the suppliers of the drugs, often in cash, and failed to report income or file corporate income taxes.  Coleman was also ordered to forfeit $20.3 million and pay $717,000 in restitution to the IRS.  				 					 

						
Tagged in:
													  Criminal Proceedings, 
													  Money Laundering, 
													  Pharma Fraud, 
													  Tax Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
April 4, 2019

				 Alexion Pharmaceuticals Inc. will pay $13 million to resolve allegations that the company violated the False Claims Act by providing funds to a purportedly independent patient assistance program for its drug Soliris in a form that created an improper kickback. Soliris, which, at list price and typical dosages, can cost as much as $500,000/year, was unaffordable to many patients.  While Alexion had a free drug program, it referred Medicare patients to a "Complement-Mediated Disease" fund for copayment assistance; Alexion then billed Medicare for the drugs.  Alexion was the sole donor to the fund, and assistance from the fund was contingent on the patient taking Soliris.   				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  Drug and DME Pricing, 
													  FCA Federal, 
													  Pharma Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
April 4, 2019

				 Pharmaceutical company Lundbeck LLC will pay $52.6 million to resolve allegations that the company violated the False Claims Act by providing funds to a purportedly independent patient assistance program for its drug Xenazine, approved for Huntington's Disease, in a form that created an improper kickback. Lundbeck was the sole donor to a fund at a foundation that claimed to provide financial support for patients with Huntington’s Disease. However, Lundbeck also referred Xenazine patients with many other conditions to this foundation, which then paid the Xenazine copays for these off-label uses.  When the foundation determined to stop using its Huntington's fund for non-Huntington's patient, Lundbeck redirected its payments to a different general-purpose fund, with the understanding that fund would use the redirected funds to pay Xenazine copays for these same patients.  Lundbeck is alleged to have denied needy Medicare and ChampVA Xenazine patients access to its free drug program, instead referring them to the patient assistance program, permitting Lundbeck to submit claims to federal healthcare programs.   				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  Drug and DME Pricing, 
													  FCA Federal, 
													  Off-Label and Unapproved Use, 
													  Pharma Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
April 4, 2019

				 Jazz Pharmaceuticals will pay $57 million to settle allegations that the company violated the False Claims Act by providing funds to a purportedly independent patient assistance program in a form that created an improper kickback.  The funds provided by Jazz were used to cover the copayments for patients to purchase Jazz's drugs Xyrem, a narcolepsy medication, and Prialt, an injectable pain medication.  Jazz referred Medicare patients to the fund, and denied them access to Jazz's free drug program, enabling Jazz to bill Medicare for their purchases. 

 				 					 

						
Tagged in:
													  Anti-Kickback and Stark, 
													  Drug and DME Pricing, 
													  FCA Federal, 
													  Medicare, 
													  Pharma Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
April 4, 2019

				 Lee County Ambulance of Lexington, Kentucky, and its former director Joseph Broadwell, will pay $253,930 to settle a False Claims Act action alleging that defendants submitted fraudulent claims to Medicare for unnecessary non-emergency ambulance transports, including transportation of patients to and from dialysis treatment.  				 					 

						
Tagged in:
													  Ambulance, 
													  FCA Federal, 
													  Healthcare Fraud, 
													  Lack of Medical Necessity, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
April 4, 2019

				 Oral and Maxillofacial Surgical Associates P.C. of New Haven, Connecticut, and its former owner Robert Sorrentino DDS, have agreed to pay $252,000 to settle claims that they submitted false claims to Medicaid by billing for services that were not provided, were not medically necessary, or were covered under other claims submitted for the same date of service.  The fraudulently-billed services included deep sedation or general anesthesia and removal of bone or tissue.  				 					 

						
Tagged in:
													  Bundling and Unbundling, 
													  FCA Federal, 
													  FCA State, 
													  Healthcare Fraud, 
													  Lack of Medical Necessity, 
													  Medicaid, 
													  Medical Billing Fraud, 
													  Provider Fraud, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
April 4, 2019

				 Evelyn Mokwuah, a former administrator for Houston, Texas-based Beechwood Home Health and Criseven Health Management Corporation, was sentenced to ten years in prison for her role in the submission of approximately $20 million in false claims to Medicare.  According to the evidence at trial,  Mokwuah falsely certified and billed for patients who were not homebound or did not qualify for home health services; falsified patient records to show that patients were homebound when they were not; paid patient recruiters; and, paid doctors to certify false plans of care for Medicare beneficiaries.  				 					 

						
Tagged in:
													  Criminal Proceedings, 
													  Healthcare Fraud, 
													  Home Health and Hospice, 
													  Lack of Medical Necessity, 
												
						

					
	
							
	
		
		
	


 			




	
		
		

			

				
				
April 3, 2019

				 Sandra Ruballo and Carlos Andres Montoya were found guilty of wire-fraud, bribery, and money laundering for their role in a multi-million dollar scheme to defraud the Child Care Food Program, a federally funded food program for underprivileged children in South Florida daycare centers. The conspirators drafted fake paperwork, entered into kickback arrangements, rigged the catering bidding process and inflated annual budgets in order to secure federal funds for their own personal benefit. Ruballo is scheduled to be sentenced on May 8, 2019. Montoya is scheduled to be sentenced on June 5, 2019. Each defendant faces a maximum statutory sentence of 20 years’ imprisonment. 				 					 

						
Tagged in:
													  Bribery and Bid-Rigging, 
												
						

					
	
							
	
		
		
	


 			


											

						

								

									
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